Skin Cancer and Reconstruction
Titus Adams performs surgery to remove skin cancers, including Basal Cell Carcinoma (BCC), Squamous Cell Carcinoma (SCC), and Melanoma (including the Sentinel Lymph Node Biopsy service at Oxford).
Patients tend to be referred directly via their GP or Consultant Dermatologists and Tius Adams works as part of the Skin Multidisciplinary team (MDT) where complex or concerning cases are discussed.
Reconstructive Plastic Surgery is often required as the skin cancers can be extensive or the area for reconstruction is devoid of local skin to aid closure. Skin flaps or skin grafts are often required to fill the hole or defect once the skin cancer has been removed.
Local Skin Flaps
Skin flaps are employed, particularly on the face, to replace like-for-like skin colour, thickness and texture. The scars are then designed to hide in the most suitable parts of the face to minimise their appearance which takes place some weeks or months later. .There are many different designs of flap and their use is dependent on the size of the defect, the type of skin tissue available and the site in which the defect resides.
If the defects are much larger, then skin grafts are required. Their use can be likened to replacing a piece of bad lawn turf with fresh new lawn turf. Two types of skin graft can be used. Full thickness skin grafts can be used (typically from spare skin in the neck) or split thickness skin grafts (often taken from the thigh) similar to that used in the treatment of burns. Both skin grafting techniques have advantages and disadvantages and their use is usually governed by the extent of the defect after the skin cancer is resected.
Titus Adams is currently the Clinical Director for NHS Plastic Surgery Services in Berkshire. In the NHS, he developed the skin cancer services hub at the West Berkshire Community Hospital in which day case NHS skin cancer surgery is performed. He also performs skin cancer and its reconstructive surgery in private hospitals in Oxford and Reading. Sentinel Lymph Node Biopsy for Melanoma is exclusively performed at the John Radcliffe Hospital under a general anaesthetic as part of the treatment options available for Melanoma.
All major healthcare insurance companies recognise Titus Adams as a Plastic Surgeon with a specialist interest in this work.
Before and After Gallery
62 year old man post-op skin cancer excision on left temple with advancement flap reconstruction
Breast lift – removal of 15 year old implants and auto augmentation mastopexy technique in 52 year old (before and 6 months after surgery)
74 year old, 3 months post-op excision of BCC right nose and Bilobed flap reconstruction
36 year old lady, before and post-op BCC excision with off-set flap reconstruction
Elderly lady with 20 year history of BCC left posterior shoulder before and immediately after excision and reconstruction using a Latissimus Dorsi (LD) flap